CHAPTER 1. MEDICAL SERVICES FOR INMATES AND PATIENTS

IC 12-16
    ARTICLE 16. PAYMENT FOR HEALTH SERVICESOTHER THAN MEDICAID

IC 12-16-1
    Chapter 1. Medical Services for Inmates and Patients

IC 12-16-1-1
"Affected agency" defined
    Sec. 1. As used in this chapter, "affected agency" means any ofthe following:
        (1) The department of correction.
        (2) The state department of health.
        (3) The division of mental health and addiction.
        (4) The division of disability and rehabilitative services.
As added by P.L.2-1992, SEC.10. Amended by P.L.40-1994, SEC.22;P.L.215-2001, SEC.46; P.L.141-2006, SEC.56.

IC 12-16-1-2
"Covered medical services" defined
    Sec. 2. As used in this chapter, "covered medical services" refersto medical services that meet the following qualifications:
        (1) Cost more than one hundred fifty dollars ($150).
        (2) Are provided to a committed individual or patient of aninstitution under the jurisdiction of an affected agency.
        (3) Are provided outside of an institution under the jurisdictionof an affected agency.
As added by P.L.2-1992, SEC.10.

IC 12-16-1-3
Rules; adoption; requisites
    Sec. 3. (a) The division shall, with the advice of the division'smedical staff, representatives of affected agencies, and otherindividuals selected by the director of the division, adopt rules underIC 4-22-2 to do the following:
        (1) Provide for prior review and approval of covered medicalservices, including special review and approval procedures foremergency covered medical services.
        (2) Establish limitations consistent with medical necessity onthe duration of services to be provided.
        (3) Specify the amount of and method for reimbursement forservices.
        (4) Specify the conditions under which payments will be deniedand improper payments will be recovered.
    (b) To the extent possible, rules adopted under this section mustbe consistent with Title XIX of the federal Social Security Act andwith IC 12-15-21-2 and IC 12-15-21-3.
As added by P.L.2-1992, SEC.10.
IC 12-16-1-4
Contract for services; same contractor requirement
    Sec. 4. (a) The division shall contract with the same contractorwith which the office contracts under IC 12-15-30 to provideadministrative and fiscal services to implement this chapter.
    (b) A contract for services is not subject to IC 5-22.
As added by P.L.2-1992, SEC.10. Amended by P.L.49-1997, SEC.45.

IC 12-16-1-5
Payment for covered medical services; requirements
    Sec. 5. Payment for covered medical services approved by thefiscal agent shall be paid:
        (1) from money for the Medicaid program if the requirementsof IC 12-15 are met; or
        (2) if a payment cannot be made under subdivision (1), from astate appropriation either made for an affected agency or forcovered medical services for all affected agencies.
As added by P.L.2-1992, SEC.10.